scholarly journals The Role of Radiotherapy in Hodgkin’s Lymphoma: What Has Been Achieved during the Last 50 Years?

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Magdalena Witkowska ◽  
Agata Majchrzak ◽  
Piotr Smolewski
Keyword(s):  
Radiation Therapy ◽  
Safety Profile ◽  
Hodgkin’S Lymphoma ◽  
Antitumor Agents ◽  
Standard Of Care ◽  
Hodgkin's Lymphoma ◽  
Field Size ◽  
Field Radiation ◽  
Involved Field

Currently, Hodgkin’s lymphoma (HL) has an excellent clinical outcome, with overall survival of approximately 90% in early stages of the disease. Based on young age of the majority of patients at the time of diagnosis and their long survival time, increased attention has been focused on long-term toxicity of therapy. While novel, directly targeting antitumor agents, with an excellent safety profile, have been developed for HL treatment, the role of radiotherapy is still debated. Radiotherapy may induce cardiovascular disease and impairment of thyroid or pulmonary function and, most importantly, may lead to development of secondary cancers. As a consequence, the current radiation therapy planning paradigm is mainly focused on a reduction of field size. As it was investigated in clinical trials regional therapy is as effective as extended field radiotherapy, but less toxic. Although chemotherapy is the mainstay of HL treatment, consolidative involved field radiation therapy is still considered to be the standard of care in both early and advanced stages. Recently, further field reduction has been investigated to further decrease the late radiation-induced toxicity. In this paper we describe the role and safety profile of radiotherapy in the past and present and hope for the novel techniques in the future.

Role of FDG-PET in the Definition of Involved-Field Radiation Therapy and Management for Pediatric Hodgkin's Lymphoma

2011 ◽  
Vol 80 (2) ◽  
pp. 324-332 ◽  
Author(s):  
Virginia Lang Robertson ◽  
Cynthia S. Anderson ◽  
Frank G. Keller ◽  
Raghuveer Halkar ◽  
Michael Goodman ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Fdg Pet ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Field Radiation ◽  
Pediatric Hodgkin’S Lymphoma ◽  
Definition Of ◽  
Involved Field

Involved-Nodal Radiation Therapy As a Component of Combination Therapy for Limited-Stage Hodgkin's Lymphoma: A Question of Field Size

2008 ◽  
Vol 26 (32) ◽  
pp. 5170-5174 ◽  
Author(s):  
Belinda A. Campbell ◽  
Nick Voss ◽  
Tom Pickles ◽  
James Morris ◽  
Randy D. Gascoyne ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Hodgkin’S Lymphoma ◽  
Combined Modality Therapy ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
Hodgkin's Lymphoma ◽  
Field Size ◽  
Limited Stage ◽  
Increased Risk ◽  
Field Radiation

Purpose Combined-modality therapy is the standard of care for limited-stage Hodgkin's lymphoma (HL). Radiation therapy has evolved from extended-field radiation therapy (EFRT) to involved-field radiation therapy (IFRT), reducing toxicity while maintaining high cure rates. Recent publications recommend a further reduction to involved-nodal radiation therapy (INRT), however, this has not been clinically validated. Patients and Methods We identified 325 patients with limited-stage HL, diagnosed between May 1, 1989 and April 1, 2005, and treated with chemotherapy and radiation therapy following era-specific guidelines: EFRT until 1996; IFRT from 1996 to 2001; INRT ≤ 5 cm from 2001 to the present. INRT ≤ 5 cm was defined as the prechemotherapy nodal volume with margins ≤ 5 cm to account for physiological movement, set-up variation, and the limitations of conventional simulation and radiation therapy techniques. Exclusion criteria were age younger than 16, fluorine-18 fluorodeoxyglucose positron emission tomography, non–doxorubicin, bleomycin, vinblastine, and dacarbazine-like chemotherapy, and/or more than four chemotherapy cycles. Results At diagnosis, median age was 35 years; 52% male; stage IA 29%; stage IIA 71%. Ninety-five percent of patients received two chemotherapy cycles. The three radiation therapy groups were: EFRT, 39%; IFRT, 30%; and INRT ≤ 5 cm, 31%. Median follow-up of living patients was 80 months. Median time to relapse was 37 months. Twelve relapses occurred: four after EFRT (3%); five after IFRT (5%); and three after INRT ≤ 5 cm (3%; P = .9). No marginal recurrences occurred after INRT ≤ 5 cm. Locoregional relapse (LRR) occurred in five patients: three after EFRT; two with IFRT; and none with INRT ≤ 5 cm. At 5 years, progression-free survival (PFS) was 97%, and overall survival (OS) was 95%. At 10 years, PFS and OS were 95% and 90%, respectively. Conclusion Reduction in field size appears to be safe, without an increased risk of LRR in patients receiving INRT ≤ 5 cm.

scholarly journals Recurrent and Hodgkin’s lymphoma-associated multicentric Castleman’s disease in head and neck region

2020 ◽  
Vol 6 (10) ◽  
pp. 1882
Author(s):  
Vinodh Kumar Selvaraj ◽  
Deleep Kumar Gudipudi
Keyword(s):  
Monoclonal Antibodies ◽  
Hodgkin’S Lymphoma ◽  
Treatment Options ◽  
Castleman’S Disease ◽  
Neck Region ◽  
Hodgkin's Lymphoma ◽  
Castleman's Disease ◽  
First Case ◽  
Field Radiation ◽  
Involved Field

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong><span lang="EN-US">Castleman’s disease (CD) is a rare lymphoproliferative disorder. It can involve single (unicentric CD) or multiple (multicentric CD) lymph nodal regions. It occurs predominantly in mediastinum, and treatment options include surgery, radiotherapy, chemotherapy, and monoclonal antibodies. </span></p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> Here, we describe two cases of CD which presented with stridor. The first case was a 38-year-old male, a recurrent multicentric CD in retropharyngeal and cervical lymph nodal regions, treated with radiotherapy and rituximab. The second case was a 25-year-old male, a multicentric CD in lower cervical lymph nodal region, treated with steroids and radiotherapy. He subsequently developed Hodgkin’s lymphoma and was treated for the same with chemotherapy and involved-field radiation therapy (IFRT).</span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong><span lang="EN-US">Post-treatment, both the patients were asymptomatic and progression-free at 15 months and 42 months follow-up, respectively.</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong><span lang="EN-US">Combined modality of treatment with radiotherapy and chemotherapy or monoclonal antibodies offers good local control in multicentric CD.</span></p>

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